A rare presentation of craniopharyngioma: Delayed Puberty; A case report and literature review

Abstract

Background: Craniopharyngiomas are among the most common suprasellar tumors in children and adolescents. Owing to their slow-growing and indolent nature, patients may remain asymptomatic for prolonged periods or may present with visual disturbance or headache. Delayed puberty resulting from hypopituitarism is a recognized clinical feature.
Case Report: We describe a 23-year-old male who presented with short stature and absent pubertal development. His clinical and biochemical evaluation revealed panhypopituitarism. MRI of the brain demonstrated a large suprasellar mass with radiologic features consistent with craniopharyngioma. The patient did not report headache, visual symptoms, or polyuria.
Discussion: Suprasellar masses may present with non-specific or atypical symptoms, and the absence of headache or visual disturbance does not exclude significant underlying pathology. Clinicians should maintain a high index of suspicion for hypopituitarism when evaluating individuals with unexplained short stature.
Conclusion: Early assessment of children and young adults with short stature, particularly when accompanied by lethargy, is essential to avoid delayed diagnosis of significant endocrine or structural abnormalities. For patients who decline surgical management, appropriate hormone replacement therapy can provide meaningful symptomatic improvement.